Risk factor analysis and etiological pathogen spectrum for urinary tract infection in children
DOI:
https://doi.org/10.14739/2310-1210.2025.3.323423Keywords:
children, urinary tract infection, uropathogens, risk factorsAbstract
The problem of urinary tract infection (UTI) in children remains relevant in modern pediatrics, pediatric nephrology, and urology, despite the large number of works focused on this issue studies.
Aim. To analyze the potential predictors of development and examine the etiological spectrum of pathogens for urinary tract infection in children.
Materials and methods. Medical documentation of 238 children aged 1 to 14 years was analyzed. Children were divided into two groups: I – children with UTI (n = 140), II – children without UTI (n = 98). The patient group inclusion criteria for children with UTI met the recommendations of the European Society of Pediatric Urology. Urine culture for microbial flora and antibiotic sensitivity were performed according to standard methods.
Results. UTIs occurred in 32.7 % of boys and 26.1 % of girls. The most frequent UTIs were registered in the 1–3 years age group (54.3 %). Sex-specifics of UTIs were noted, varying depending on age: at the age of 1–3 years, girls were 1.3 times more likely to have UTIs than boys (95 % CI: 0.8–2.5); at the age of 4–7 years, boys were 1.4 times more likely to have UTIs (95 % CI: 0.9–3.4) than girls. Most common in children were vesicoureteral reflux (passive 34.5 % and active 19.2 %), cryptorchidism (12.1 %), and pyelectasia (10.3 %). According to the results of questioning, a positive family history of nephro-urological diseases was found in 35.7 % of patients. Age, heredity, neurogenic bladder, duration and number of hospitalizations, anomaly, congenital defect, constipation, intestinal dysbacteriosis, and anemia were identified as factors influencing UTI in children (p < 0.05), while factors such as sex, place of residence, seasonality, and diabetes mellitus had no significant effect. Gram-negative bacterial flora was predominantly identified including Escherichia coli in both observation groups, Klebsiella oxytoca and Acinetobacter baumannii were isolated more often than other microorganisms.
Conclusions. The predominant pathogen in the development of pediatric urinary tract infections is Escherichia coli. Identification of UTI microbiological spectrum will allow for rapid and rational initiation of empirical antibacterial therapy. Independent risk factors for UTI development should be considered when developing strategic guidelines for prevention, early diagnosis, and treatment approaches.
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